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Increased Prevalence of Major Congenital Anomalies in Births With Placental Abruption

Riihimäki, Outi MD; Metsäranta, Marjo MD, PhD; Ritvanen, Annukka MD; Gissler, Mika MSocSc, PhD; Luukkaala, Tiina MSc; Paavonen, Jorma MD, PhD; Nuutila, Mika MD, PhD; Andersson, Sture MD, PhD; Tikkanen, Minna MD, PhD

doi: 10.1097/AOG.0b013e31829a6f91
Original Research

OBJECTIVE: To examine the association between major congenital anomalies and placental abruption.

METHODS: A register-based retrospective case–control study was carried out from 1987 to 2005. Data on baseline characteristics and birth outcomes were collected from three Finnish national health registers: the Medical Birth Register, National Hospital Discharge Register, and Register of Congenital Malformations. The study population consisted of 4,190 women with singleton birth and placental abruption. Three control women without placental abruption were selected for each case, matched by maternal age, parity, year of birth, and hospital district. The main outcome measure of the study was a major congenital anomaly associated with placental abruption.

RESULTS: In total, 261 (prevalence 623/10,000) births with placental abruption and 415 (prevalence 330/10,000) control births had major congenital anomalies (odds ratio [OR] 1.92, 95% confidence interval [CI] 1.6–2.52). The association was strongest among births with growth restriction and prematurity. Adjusted analysis revealed a significant association with central nervous system anomalies (OR 2.33, 95% CI 1.29–4.23), anomalies of the eyes and ears (OR 1.82, 95% CI 1.08–3.09), cardiovascular anomalies (OR 1.78, 95% CI 1.34–2.37), respiratory anomalies (OR 3.51, 95% CI 1.56–7.90), gastrointestinal anomalies (OR 3.81, 95% CI 2.27–6.41), genitourinary anomalies (OR 2.55, 95% CI 1.73– 3.74), musculoskeletal anomalies (OR 1.67, 95% CI 1.24–2.24), and anomalies of integument (OR 3.29, 95% CI 1.20–8.98) in births complicated by placental abruption.

CONCLUSIONS: Major congenital anomalies are twice as common among neonates born from pregnancies complicated by placental abruption compared with control pregnancies without abruption. This observation applies to several organ systems.

LEVEL OF EVIDENCE: II

The prevalence of major congenital anomalies is nearly doubled in births complicated by placental abruption.

Department of Obstetrics and Gynecology and Children's Hospital, University Central Hospital, Helsinki, the THL National Institute for Health and Welfare, Helsinki, and the Science Center, Pirkanmaa Hospital District and School of Health Sciences, University of Tampere, Tampere, Finland; and the Nordic School of Public Health, Gothenburg, Sweden.

Corresponding author: Outi Riihimäki, MD, Department of Obstetrics and Gynecology, University Central Hospital, 00029 Helsinki, Finland; e-mail: outi.riihimaki@hus.fi.

Supported by the Helsinki University Hospital Research Grants and grants from the Emil Aaltonen Foundation.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2013 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.